Aging Male最新文献

Background: Digital health literacy (e-HL) is an increasingly popular analysis of patients' awareness of appropriate treatment modalities. This study aimed to evaluate e-HL levels in men undergoing Holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH) and its potential impact on their quality of life.

Methods: A total of 106 patients scheduled for HoLEP were included. Age, body mass index (BMI), prostate-specific antigen (PSA), prostate volume, preoperative uroflowmetry values, e-HL scores, International Standard Classification of Education (ISCED) levels, and internet usage data were recorded. The EuroQoL Quality of Life (EQ-5D-5L) questionnaire was administered at three months postoperatively. Follow-up uroflowmetry results, IPSS scores, and quality of life (QoL) assessments were compared with e-HL scores. A cutoff value for digital health literacy was identified.

Results: The mean age was 68 years, BMI 29.1 kg/m², prostate volume 86.6 cc, and PSA 7.5 ± 4.6 ng/ml. The mean e-HL score was 16.8 ± 9.8, which was negatively correlated with age and BMI, positively with ISCED level and internet use (p < 0.001). The cutoff for adequate e-HL was 18.5. No significant correlation was found between e-HL and postoperative IPSS, EQ-5D-5L scores.

Conclusion: e-HL levels in HoLEP patients were not associated with symptom severity, postoperative outcomes, or quality of life. Further multicenter studies are needed.

Background: Prostate cancer (PC) is a common malignancy in older adults. We aimed to construct a nomogram for the overall survival (OS) of elderly patients with locally advanced PC who received radiotherapy and surgery.

Methods: Clinical and pathological information was downloaded from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. The selected patients were randomly divided into a training cohort and a validation cohort at a ratio of 7:3. Univariate, multivariate Cox, and stepwise backward regression analyses were used to identify independent risk factors for OS.

Results: A total of 2810 elderly patients with locally advanced PC who received radiotherapy and surgery from 2010 to 2015 were included in this study. Age, marital status, Gleason score, tumor stage were identified as independent risk factors for PC patients. Age and marital status primarily reflect background mortality risk. The nomogram demonstrated favorable discrimination and calibration, with AUCs of 0.676-0.774 for 3-, 5-, and 8-year OS, indicating good predictive performance. Decision curve analysis further confirmed its superior clinical net benefit compared with the traditional tumor-node-metastasis staging model.

Conclusions: We developed a new nomogram to predict OS in elderly patients with locally advanced PC treated with radiotherapy and surgery.

Background: To investigate the associations between various patterns of physical activity (PA) and risk of hip fracture in Chinese middle-aged and older adults.

Methods: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. PA levels, including moderate-to-vigorous (MVPA), vigorous (VPA), moderate (MPA), low (LPA), and total physical activity (TPA), were assessed using the International Physical Activity Questionnaire. Cox proportional hazard models were used to estimate hazard ratios (HRs), and a restricted cubic spline analyzed the dose-response relationship between TPA and hip fracture.

Results: Among 6,193 participants (mean age 59.3; 54.0% female), 264 hip fractures occurred during follow-up. Meeting WHO-recommended MVPA levels ≥150 min/week) was not associated with reduced risk (HR 1.04, 95% CI 0.80-1.35). Similarly, no significant associations were observed for VPA (≥75 min/week), MPA (≥150 min/week), LPA (≥300 min/week), or TPA (≥600 MET-min/week). Dose-response analysis also showed no association between total PA and hip fracture.

Conclusion: This study does not support the WHO recommendation of ≥ 150 min/week of MVPA for reducing hip fracture risk in this demographic. As PA was self-reported and largely work-related, future research should investigate leisure-time and objectively-measured PA.

Background: The association between hypertension and kidney stones remains inconsistent. This research investigated the relationship between hypertension and the risk and progression of kidney stones.

Methods: A cross-sectional analysis was performed using data from the National Health and Nutrition Examination Survey (NHANES). The association was assessed with a multivariable logistic regression model. Furthermore, a two-sample Mendelian randomization (MR) analysis was conducted to evaluate causality. Methods included inverse-variance weighted (IVW), weighted median, and sensitivity analyses. Summary-level data for kidney stones were obtained from the UK Biobank, and for hypertension from a genome-wide association study (GWAS)analysis.

Results: The NHANES analysis included 21,740 participants. After full adjustment, hypertension was significantly associated with a higher prevalence of kidney stones (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.19-1.56, p < 0.001). In the MR analysis, the IVW method indicated a causal effect of hypertension on kidney stones (OR = 1.01, 95% CI: 1.00-1.01, p = 0.013), supported by the weighted median method (OR = 1.01, 95% CI: 1.00-1.02, p = 0.002). Sensitivity analyses revealed no significant heterogeneity or pleiotropy.

Conclusions: Our investigation revealed a heightened risk of kidney stones linked to hypertension, which necessitates validation through further large-scale prospective cohort studies.

Background: The Charlson Comorbidity Index (CCI) quantifies multimorbidity, but its link to erectile dysfunction (ED) remains underexplored.

Methods: Using data from the National Health and Nutrition Examination Survey (NHANES), our study investigated the association between CCI and ED. Our analysis involved weighted multivariate regression, subgroup analyses, restricted cubic spline (RCS) analyses, and propensity score matching (PSM) analyses.

Results: Among the 2295 adults included in this study, 863 (37.6%) were diagnosed with ED. Weighted multivariate regression analyses revealed a significant positive association between the CCI and the risk of ED. Each additional point on the CCI was associated with a 32% higher risk of ED (OR 1.32, 95% CI 1.18-1.47). Furthermore, when participants were categorized into two groups based on CCI scores (CCI = 0 and CCI ≥ 1), the risk of ED was notably higher for those with CCI ≥ 1, showing a 122% increased risk compared to those with CCI = 0 (OR 2.22, 95% CI 1.62-3.05). Sensitivity analyses, including subgroup analyses and PSM, consistently supported the strong positive correlation between the CCI and ED.

Conclusion: Our study indicates that a higher CCI is positively correlated with an increased risk of ED, suggesting that lower CCI scores are associated with lower risk of ED.

Background: The current study aimed to explore the potential associations between Phenotypic Age (PhenoAge)/PhenoAge acceleration (PhenoAgeAccel) and erectile dysfunction (ED).

Methods: We carried out a cross-sectional study based on data from 2360 male participants from the National Health and Nutrition Examination Survey program in the year 2001-2004. ED was evaluated according to a self-administered questionnaire. PhenoAge and PhenoAgeAccel were employed to evaluate the biological aging speed as previously reported. Weighted logistic regression analyses were performed to reveal the association between either PhenoAge or PhenoAgeAccel and ED. We also applied restricted cubic spline (RCS) models to explore the non-linearity in such associations. Sensitivity analyses were performed to detect the robustness of the main finding.

Results: Significantly higher PhenoAge and PhenoAgeAccel were observed in participants with ED compared with no ED group (both p < 0.0001). Multivariate logistic analyses exhibited significant associations of both PhenoAge and PhenoAgeAccel, either in continuous or categorical forms, with ED, with comprehensive adjustment. RCS models revealed the non-linear relationship between either PhenoAge or PhenoAgeAccel and ED. Sensitivity analyses showed the associations between PhenoAge/PhenoAgeAccel and ED remained significant.

Conclusions: Our results suggested a significantly positive association between either PhenoAge or PhenoAgeAccel and ED. Future researches are needed to verify our findings.

Introduction: Functional hypogonadism, a manifestation of testosterone deficiency in simultaneously present comorbidities, profoundly impairs quality of life in men with overweight and obesity - yet remains persistently under-recognized in clinical practice.

Findings: Lifestyle modification constitutes first-line therapy, while pharmacological and surgical interventions increasingly complement it. Both promote substantial weight loss and may reverse obesity-related hypogonadism; bariatric surgery, in particular, elicits marked rises in circulating testosterone but entails risks of bone demineralization and uncertain long-term reproductive sequelae. Notwithstanding, testosterone deficiency itself represents a key driver of secondary osteoporosis, insulin resistance, anemia, fatigue, and depression as well as sexual symptoms. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have redefined obesity therapy through profound weight reduction and cardiometabolic benefit, yet concomitant losses of lean mass raise concern over sarcopenia and skeletal fragility.

Conclusion: This focused review article aims to present a comprehensive update on the latest data concerning combining testosterone therapy with contemporary anti-obesity pharmacotherapy as a new standard of care for obese men with functional hypogonadism, uniting metabolic, vascular, sexual, cognitive, and skeletal benefits within a comprehensive strategy to fortify corporeal resilience and enhance quality of life.

Background: The monocyte-to-high-density lipoprotein cholesterol ratio (MHR), an indicator of inflammation and lipid metabolism, has demonstrated significant clinical potential. The study aims to investigate the association between the MHR and total testosterone (TT) levels, as well as testosterone deficiency (TD) risk, utilizing data from the NHANES.

Methods: We analyzed data from 6,194 adult men from NHANES 2011-2016. Multivariate linear and logistic regression analyses were conducted to evaluate associations of MHR with TT levels and TD risk, respectively. Restricted cubic spline (RCS) analyses and subgroup analyses further assessed the robustness of our findings.

Results: In the fully adjusted model, each unit increase in log-transformed MHR was associated with a decrease in TT (β = -47.91, 95% CI: -62.39, -33.43, P < 0.001) and an increase in TD risk (OR = 1.81, 95% CI: 1.46, 2.24, P < 0.001). RCS analysis confirmed a linear relationship, and the findings were consistent across subgroup analyses.

Conclusions: This study showed that in the United States (US) adult men, a high MHR is linked to low TT levels and a higher TD risk. These findings suggest MHR could be a useful marker for early detection of low testosterone and TD risk, warranting further prospective research for confirmation.

Introduction: Corporoplasty is typically accompanied by circumcision to prevent complications such as phimosis, foreskin edema, and necrosis, yet supporting evidence is limited. We reassessed the need for concomitant circumcision by quantifying postoperative phimosis and exploring associated comorbidities.

Methods: In this single-centre retrospective cohort study, 69 of 191 men who underwent corporoplasty between 2010 and 2023 met predefined criteria. Patients with incomplete records, refusal to participate, or loss to follow-up were excluded. Data collection involved the administration of a questionnaire to patients, supplemented by data retrieved from medical databases. The median age was 55 years (range 17-70 years).

Results: 48 of 69 patients did not undergo circumcision either before or during the corporoplasty. Only 3 out of the 48 patients (6.25%) developed post-surgical phimosis. No post-surgical foreskin necrosis were reported. A relevant finding was type2 diabetes mellitus as a significant risk factor for post-surgical phimosis (p < 0.0038). Additionally, the negative impact of the degree of curvature on post-surgical glans penis sensitivity was identified (p = 0.027).

Conclusion: Our findings advocate against the obligatory practice of circumcision performing corporoplasty. Nonetheless, our results emphasize the importance of counseling patients with type2 diabetes mellitus due to their heightened susceptibility to post-surgical phimosis development.